How Body Dysmorphic Disorder Works

People who suffer with body dysmorphic disorder have a distorted, unhealthy view of their bodies. Learn more about this compulsive disorder in the following podcast from HowStuffWorks.com.

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Episode Transcript

Speaker 1 (00:00):
Brought to you by the reinvented two thousand twelve camera.
It's ready. Are you welcome to stuff you should know
from house Stuff Works dot Com. Hey, and welcome to
the podcast. I'm Josh Clark. There's Chuck Bryant. Hi, Chuck. Hi,

(00:21):
how's it going. I just thought to try and throw
you off, But that can't happen. Dude, you were pro
Thanks Chuck. I appreciate that. Imagine if I took off
my shirt and that way might be unsettling enough to
throw you. Nope, you want to try new Come on,
this will actually work really well with the topic at hand.
I never want Jerry to see my naked chest? Do you, Jerry?
Do you want to see his naked chest? She should

(00:43):
not want to. She's saying, Hey, let's see what you got, Chuck.
It's not gonna happen, all right. What do you want
me to take my shirt off for this? Oh? Good gosh? No, okay, Chuck.
It's no secret to you that I grew up a
little fat kid. I want to see pictures, by the way,
I'd love to see that. I'll bring some in. Yeah,
I was a little fat kid. I was the Pillsbury

(01:05):
dough Boy was my nickname. I was chunky than thin,
and they called me the doughboy too. They push the
belly button and all that. Yeah, and I would do
the little you know, Wow, we're alike. It's so funny. Yeah, yeah, exactly.
It was kind of traumatizing. And um, I've always wondered
I had heard of body dysmorphic disorder before, and I

(01:27):
don't think I have it to a clinical degree, but
it occurs to me that, like, what I'm seeing when
I look in the mirror is not necessarily what everybody
else is seeing. I wasn't going to bring it up,
but since you did. When I read this article, I thought, Wow,
that sounds an awful lot like Josh in certain cases. Really,
are you sure you didn't read how narcissism works? Well,
that was a different article. You're like, yeah, this one's

(01:50):
definitely Josh. I think they kind of are similar in
some ways. Actually they seem to be, yeah, because they're
they're both um centered around a focus on oneself at
the expense of, you know, paying attention to your surroundings
or other people. Yeah, that was awkward. You got it
out there first. I appreciate that. Of course, Body dysmorphic

(02:11):
disorder b d D is the little abbreviation that I'm
probably gonna is because dysmorphic isn't doesn't roll off the tongue.
It's also called dysmorphophobia. Yeah, that's no, that's no better. No,
we'll called b d D. Okay, well, then let's stick
with b d D. O. It's pretty you don't have
a speech impediment as well as body dysmorphic disorder. I know.

(02:32):
Basically what we're talking about, folks out there in podcast
land is that if you're completely preoccupied with flaws on
your body, and not just one flaw, but you know several. Yeah,
your nose, which, strangely, I don't have any kind of
b d D around my nose. And I was kind
of like, I have a big nose. You don't have

(02:52):
a big nose at all. Look at this thing, dude, No,
it's not big. I have giant nostrils too. Well, that's
a different story. So it also chuck b d D
UM also frequently as a oh, what's the word. It's
a comorbidity with other mental I guess disorders like obsessive

(03:13):
compulsive disorder uh an arexia UM and uh, clinical depression,
which is why it's misdagnosed. Sometimes it's or they think
it's probably underdiagnosed. I think they about one percent of
the population UH is believed to have b d D.
But yeah, they think that that's probably much higher. For

(03:33):
a number of reasons. Number one, somebody might not want
to talk about their flaws or their therapists. Yeah, and
you don't want to come across as some vain, superficial jerk.
And uh, but you know, we both go to shrinks.
Let's just go ahead and toss that out there. I
can't believe you said that. That's a lot of disclosure, Chuck.
I think I think healthy people go to shrinks. As
my shrink always says, I'll worry about the people who

(03:54):
don't go to shrinks. Yeah, those are the ones that
dress up in black and shoot up schools, right of
cour She says that, as I'm writing the check. So yeah, right,
just keep coming back, chump. So yeah, people are afraid
to say that to uh, their their psychiatrists or psychologists.
They're ashamed of the flaw so much that they don't
want to discuss it at all. Not just being ashamed
of being vain, they're so ashamed of their pot bilio

(04:16):
or whatever. Or they may be a lot more likely
to go to say a cosmetic surgeon over you know,
a psychoanalyst of some sort, which I'll go ahead and
ruin this one too. They don't The results of cosmetic
surgery usually don't work when you have b d D. No,
this was scary. You'll get the surgery and you'll still
be really you're worried that it's going to come back,

(04:37):
or your obsession will will transfer over to another part
of your body, right, or you get really angry at
the surgeon and say that they didn't fix it right right, Yeah,
which is that's it's a scary profession for a number
of reasons. So John Rivers, I think might be high
on the list you think. Have you seen her lately?
I feel bad for people who are who don't who
get tons of cosmetic surge. I mean, think about like that,

(04:59):
the the depth of their self loathing that that they
continuously go there junkies for it. Yeah. I don't know.
It's hard for me to drum up a lot of
compassion there, but I guess you're right. That's a good point, thanks, Chuck.
Not I feel somewhat shamed or you should feel shamed,
and not just about your body. Right, But the point
is John Rivers looks like a c trout? So is

(05:21):
that even really that's just what? Yeah, she looks like
a speckled trout. So bad to b d D. Yeah,
we we hit upon something. I said that the obsession
will transfer. B d D is a compulsive disorder. The
symptoms of it are repetitive and irresistible. Basically, what are
some of the symptoms for people out there who are thinking, huh,

(05:43):
I used to be a fat kid? Well, h this
is pretty obvious. But constantly checking your appearance in the
mirror or avoiding mirrors in reflective surfaces entirely true and
go either into the spectrum. Yeah that makes sense. Um,
Constantly comparing your appearance to others check uh, picking at

(06:04):
or otherwise attempting to fix an imagined flaw like excessive grooming.
Yeah check, yeah, I guess, measuring, touching or checking the defect,
changing your clothes a lot, refusing to be photographed, constantly
asking for reassurance about your appearance check, check and check. Camouflaging,

(06:26):
masking or disguising the flaw. Um, I do wear a
lot of makeup. Like if you have a big belly,
like we're in this big Hawaiian shirts and you know,
you're just a fun fact guy there. Yeah, that is
a signal to everybody else that you're a fact guy.
If you wear Hawaiian shirts all the time, happily, everybody
also just thinks that you're ready to party in the

(06:46):
life of the party. I see, I have a bit
of a belly, as it were, And this is a
known fact. But I found that when I wear a
tighter shirt and not tight but you know, a fitting,
fitting shirt, people say, hey, dude, you look like you've
lost weight. But if I wear the movement, oh no, yeah,
it definitely actually makes you look bigger when you reached
when you reach a certain point of um, I guess

(07:09):
weight loss or something, especially if you go from chunky
year right, well, you've you've pretty spelt now. But but
when I definitely hit a point where I realized, like
I look fatter in extra large shirts than in large shirts. Yeah, exactly.
It's a it's a good realization, it is. Uh. That's
that's all the big ones. Anxiety and fear when you're
around other people. Obviously excessive dieting and exercising that thing,

(07:32):
suicidal thoughts. Yeah, that's the really downside, I guess, when
you're at your worst. And actually there's a lot of
people who I think something like on the order of
eight percent of people who have been diagnosed with b
d d UM have reported that they've considered suicide, and
about um have actually tried it. I don't know how
many successfully, but yeah, yeah, that's really sad. It is

(07:54):
sad because you know, I mean, you're at the point
where you just hate yourself so much. You know, you're like,
I'm just gonna try this over again, right, And as
with most disorders, that's the darkest end of the spectrum.
And there is a big range from mild to really severe.
I'll tell you the dark end of the spectrum, my friend.
Are you ready for this one? People with b d
D sometimes self performed surgery. Yeah. Can you imagine mutilating

(08:20):
yourself now to just try to get rid of this flaw,
because you know, a love handle isn't is much worse
than a gaping wound where like this missing missing hunkle
flesh used to be. Yeah, I think alcohol might be involved,
you know, I could see someone just getting completely ripped
and you're like I gotta get rid of you to
get out of the kitchen knife and gone. That was

(08:44):
really that was chilling, And actually we're making a lot
of that that that does happen and people do reach
those steps, so that that's an awful thing to make
fun of, sure, which you just did. I was just
trying to reenact what it might be like, Yeah, well, Chuck,
thank you for that. It's actually what happened to me
last Friday. And is it when you carve off just
a little bit of a love handle and then I

(09:04):
was like, oh, I thought you looked like you'd lost
some weight. Yeah, just a hand of a love handles
very painful. So let's talk about what b d D is.
You know, we're not entirely certain how a person gets
this or you know, we know how it, uh it
manifests itself, but we're not entirely certain what's going on.
Because if you think about it, it's kind of bizarre

(09:24):
that you don't see yourself the way other people do
when you know you're looking at your reflection in a mirror. Right.
I think a lot of people have that to a
certain degree, because I mean, how many people when they
see a photo of themselves say, God, do I look
like that? Minds always do I sound like that? Really?
You got a great voice, though, thank you. Uh. They've

(09:46):
done some research as far as the biological causes. Let's
go ahead and start with the biological said, okay. And
some researchers showed twenty five people, um half of which
so I guess twelve and a half people I've noticed
that had b d D and the they're have did not.
And they would show them three different images of faces
and different resolutions high, regular and low, large, medium, and small,

(10:08):
all right, And they hooked them up to an m
r I and they showed that the b d DE
folks use the left side of their brain, which is
the analytical side, indeed, to process all of the images,
and the other participants use the left hemisphere only for
the high res images. So that means, Josh, is that
or what it could mean is that the minds, the

(10:28):
brains of people with b d D want to acutely
process visual details. Even when there are no visual details,
they're always looking for. That. That's one explanation. It's reasonable.
Moving on, I've got one better for you. Hit me.
It's much more likely, in my opinion, that it is
an imbalance in the brain chemistry, specifically with the uptake

(10:50):
of serotonin. All right, let's hear it, all right, So
serotonins and neurotransmitter, right, and it's produced in the brain.
Um actually can be produced anywhere in the body. But
the stuff that affects your mood and sleep and things
like that, it's actually produced in the brain by trip
to fan. A trip to fan, as you know, is
from you know, you can find it in Turkey. It's
an amino acid. Everyone says it makes you go to

(11:12):
sleep supposedly. Actually ironically, tripp to fan works best on
an empty stomach. And when you eat a bunch of
stuff at Thanksgiving cover and I think we did too
solds of stuff there. Well, basically gorge yourself and right,
you're actually digesting that's just making you sleepy. But tripp
to Fan is uh is uncommon in that it's one

(11:32):
of the few amino acids that can cross the blood
brain barrier. So you eat some trip to fan, it
gets separated from your turkey and crosses the blood stream
into the brain, where it's used as an essential ingredient
in serotonin production. Right, in a paddle book. Yeah, what
I understand. Yeah, with the giant frog. And so once

(11:53):
the trip to fan gets the brain, YadA, YadA, YadA.
You got serotonin, right? Did you like that explanation? Very scientific?
Serotonin is trans It's a neurotransmitter. So it goes from
the pre synaptic neuron, which is the one where it's produced,
to the post synaptic neuron where it's accepted. But it
loses a little love on the way. It does not

(12:14):
all of its um taken in by the post synaptic
neuron um, and it's just kind of floating there in
the synaptic cleft, the space between neurons where these electrochemical
messages are firing between um and actually that can be good.
If if it accumulates too much, then that's not too
good because you've got basically a blockage and you have

(12:35):
enzymes that actually clear out the serotonin. But you if
it lingers a little longer um, the the communication is stronger. Right.
What ss R eyes are serotonin? I'm sorry, Selective serotonin
reuptake inhibitors do? They actually prevent some of the serotonin

(12:55):
from being taken back by the pre synaptic neuron. So
we're talking to pro right these things. Yeah, what they
do is they they allow some of the serotonin to linger,
which makes for a stronger message, which improves mood. Actually,
it's stabilizes mood. What we're seeking is a stable mood
rather than ups and downs. That makes sense to me,
does it really? Holy cow? Well, I mean, not only

(13:18):
did you do a fine job of of laying that
out there, but I think anytime you're dealing with something
like this, Sure there's certain other explanations, but the brain, dude,
that's where it's at. I agree. The brain is the thing.
So the reason why they think that this is, uh,
this is that b d D is a chemical imbalanced.
So the result of chemical imbalance is because b d

(13:39):
D patients respond very well to UM selective serotonin reuptake
inhibitors like zoo OFFT and stuff like that paxel uh
so so selects all loss prozac, you know, all those antidepressants,
all that good stuff. Um, cultural factors? Should we talk
about that? Are we done with biology? Those are the

(14:01):
only two theories that I know, Um, the are going
on right now? Biologically? Okay, Well, let's move over to
the to the cultural and physiological side of things. Which
um this one. You know, of course, the media and
magazine it does. Media is too lazy to really do
anything that's actively bad in my opinion. Yeah, that's true.
I think it's all the results of just an an

(14:22):
ability to do real research. Yeah. True, that's pretty lazy
to blame it on the media, But we'll do that
right now. The media, of course, with all the perfect
bodies and the perfect faces. That certainly doesn't help. I
don't think it can cause this, but I don't think
it helps the situation. If you were born with like
a mile case of b d D, you uh, seeing
you know, Gizel on the cover of a magazine probably

(14:44):
make you feel any better about the hairy mole on
your lip. Probably not, although if you see a picture
of Cindy Crawford you probably feel pretty good about the
Harry mole on your lip. That's a beauty mark, buddy,
same thing. It all depends on what face it's It's exactly. Yeah.
I always thought that was pretty funny because that on
my face would be a male or worse. Yeah, they're

(15:07):
talking Sidney Crawford. Not too bad. It would command you
to burn things, is that Simpsons? Yea? Was it? Yeah,
Ralph's lepre Coron commands him to burn things. I thought
you meant the talking mall part. So uh yeah, those
are the societo cultural theories, and um, this is the
one that they documented as far back as the eighteen hundreds.

(15:30):
So that's so funny. You just referenced another podcast. I know,
I'm all over the place. Yeah, but which kind of
undermines the idea that it's media sensationalism because it was
before media. Well, yeah, pretty much. I mean, would you
have like this the Saturday Evening Post in there, right,
they showed a little ankle and all of a sudden,
you know, women are like, my ankles don't look like that, right,
Norman Rockwell is disturbing millions of people. And I think

(15:53):
also this would be a good point to say that
this does not just affect women, It affects men as well.
Oh yeah, sure, but in a very sexist way. Men
have their own version of it, muscular body dysmorphia, right,
which is the need to be buff and muscular, which
I clearly could care less about the same here, Oh yeah,
same here. But it doesn't it's not just related to

(16:15):
the muscles um or the lack of muscle. It's also
related to thinning hair genitalially speaking, it has something to
do with that. Do you ever see that one kids
in the hall with Mr cabbage Head, You remember him
where he was trying to pick some woman up and
he was like, it's not a cucumber, it's a gherkin exactly. Yeah,

(16:35):
he probably would have had a muscular body dysmorphia disorder probably,
So sure there also maybe some childhood traumas that could
kick start this whole thing, like being beaten about the
head and neck. Yeah, and that makes sense and teasing
like you were talking about. They did a study. They
found seventy percent of the participants reported maltreatment during their

(16:56):
their childhood. The study of people with b d D. Yeah,
but the study did and say whether they didn't ask
whether the mal treatment happened before after the onset would
be slightly dodgy statistic. But they also found that said
the mal treatment was severe. Al right, So that kind
of makes sense at all. I think it could be
a soup of all these things. You may be born
with a little bit of it. Society chimes in with

(17:18):
making you feel worse about yourself. You maybe your parents did,
schoolmates that kind of thing, right, But and I'm saying
this is a former fact. Kid, Eventually you have to
get to a point where you can't let other people
define you, you know what I'm saying. Eventually you have
to stand on your own two feet and just say, yeah,
I was a fat kid when I was little, and
yeah I had some jerks poked me in the stomach.

(17:40):
Who cares say it, they're they're all digging ditches right now,
do some therapy and look at you. But he I
just did. I was a late bedwinter. Oh my god, Chuck,
were you really? Holy cow? All right, let's see if
I can want up you. Um no, do it? No,
you got something worse in late bedwinter, know, and you
know for those you've got out there, they're late bedwetters.

(18:02):
It's okay, and it will stop at some point eventually.
Or you could just stop drinking and still waiting on
that day. So, Chuck, you have any more revelations? Um? Well,
it affects supposedly about one of the general population, which no, sorry,
the the b D D and so. But they think

(18:23):
that might be kind of low because of the lack
of diag diagnosis and stuff like that. Well, how do
we treat this, Chuck, I would already sayd S SR
eyes SSR eyes is one. And then you have the
old CBT cognitive behavioral therapy, Yes, which was developed in
the fifties. It's psychotherapy where you uh, it's got different approaches.
You focus on the concept that your thoughts are the

(18:43):
root of the behavior and the feelings as opposed to
like outside influences. So sort of tackling from the inside out. Um,
not eating and smoking cigarettes helps a lot too, as
I understand it. Right. So in closing, are we closing? Yeahs.
In closing, I would say, just from someone who has
had issues with weight here and there and j and

(19:04):
bed wedding is you know, no one's perfect. It's you're
gonna live a long life full of let's hope, and
you're gonna have issues with yourself here and there, get
over it and it's not that big of a deal.
Everyone has their flaws and so just except except your own. Yes,
that's my advice. Beautiful Chuck, beautiful beautiful words from a beautiful,

(19:26):
beautiful man inside and out right. Surround yourself with people
who support you, you know, and and the jerks out
there that are calling your names and stuff. They don't
know what they're talking about, you know. Yeah, we should
probably especially target this to our younger listeners to It
ends eventually, but it ends when you allow it to.
And you know what, I guarantee you and I can

(19:46):
say this is an older guy. Those same jerks who
are teasing you and poking and prodding you, like Josh said,
they're probably losers and they will go on and their
true colors will come out later, agreed, and they will
be losers for life. All right. So that's body this
morphic disorder if you uh. Actually, this is a fine
fine article written by Jessica Toothman. I thought it was
excellent tooth the tooth Um and Uh. In it, she

(20:10):
says that if you think or suspect you might have
body dysmorphic disorder, you should go to seek help from
a therapist, absolutely, even if it just seems mild, because
oftentimes it's a lot worse than you think it is. Yeah,
and you don't want to get out of hand. Yeah.
So yeah, that's bodied of dysmorphic disorders I just said,

(20:30):
which means that it is time for listener mail. Maybe
why not, Josh, I'm gonna call this corrections and suggestion,
because there's one suggestion in two corrections. I'm gonna go
to these kind of quick. This comes from Julie. She
says a geologic nitpick from the CCS podcast, the pronunciation

(20:52):
of I believe we said but salt, I said belt,
you said basalt, and she says it's actually pronounced assault
with the influence on or the emphasis on salt with salt. Right.
That comes from Julie. Our friendly neighborhood pedantic geologists is
how she builds herself. So thanks for that, Julie. Thanks.

(21:14):
This comes from Peter and this is about Tesla and uh,
the band or the guy, Yeah, Nicola Teslade and he
said that, um, and we've gotten this email from a
few folks that we were knocking DC power d C.
It's actually got lots of great applications and we didn't
highlight those. We might do that later. Is there a

(21:34):
camp of people who are fans of DC electricity? Yeah,
you stated a couple of times that DC is a
poor transmitter of electricity across long distances. Actually, a lot
of talk is going on now in the energy business
about the possibility of using high voltage DC or direct
current to transmit electricity across long distances high voltages. Direct

(21:57):
current experiences much lower line losses than a c That
is not what I understand, he said. They're looking into
a buddy. You want to take Peter to task? No, no, okay,
that means you don't want to email him back. And
then this final one is from Andrew in Nashua, New
Hampshire or Nashua unless I was pronounced. He says he

(22:18):
has an addendum to our innovations podcast and he thinks
a really cool one would be wireless electricity and don't
say battery, And he said, don't say battery. He said
that sustained sustained energy with wireless would be really cool.
So when you take out your vacuum cleaner, you just
use it around your house via wireless power, no cords

(22:39):
to trip over, having to move from outlet to outlet.
And you could have an infomercial with a woman in
black and white whose hair is all frazzled over a
vacuum cord and then looking into the camera with a
frustrated look, she blows the unkeimpt hair out of her face. Wow.
Then show her in full color, smiling from ear to
ear as she wirelessly vacuums and I think that is

(23:00):
a very sexist infomercial. Buddy. Yeah, I think you should
be a guy. This guy's really really tough this out though. Yeah,
that'd be cool. Yeah, I'm not sure how practical. It
seems dangerous if you ask me, because you'd have to
beam that electricity somehow. That's a good point, Chuck, So whatever,
but thank you. You should close et me listen to me. Yeah, whatever, whatever,

(23:22):
But we want to thank Andrew and New Hampshire for
sending that sounds like a pretty groovy idea. Thanks to
all three of you for writing in, and everybody who's
written in. Even if we haven't gotten your letters, we
actually do read every single one. It's pretty cool. Um,
if you want to send us a letter, it may
or may not be read on the air, but at
the very least you'll know Chuck's beautiful eyes have gazed
over it. Um. You can send that to stuff podcast

(23:45):
at how stuff works dot com for more on this
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(24:06):
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